{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:30:57Z","timestamp":1774535457449,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T00:00:00Z","timestamp":1516060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Carboxytherapy may generate local pain that is considered the main limiting factor in clinical practice. Transcutaneous electric nerve stimulation (<jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content>) is widely used in the control of acute pain; however, the effect of <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content> on pain relief during carboxytherapy has not been studied to date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the effect of <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content> on pain intensity during carboxytherapy in patients with cellulite in the gluteal region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>This randomized clinical trial was conducted with 84 patients, 18\u201044 years of age, who had moderate cellulite in the gluteal region, according to Cellulite Severity Scale, but never received carboxytherapy. Patients were randomized into 3 groups: active <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content>, placebo <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content>, and control group. For the intervention, skin depressions with cellulite were outlined, and the gluteal area to be treated was defined. The subcutaneous injection of <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> was performed using 0.30 \u00d7 13 mm\u2010needles at a 45\u00b0 angle, with a controlled flow rate of 100 mL\/min maintained for 1 minute at each puncture site. The parameters for <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content> were as follows: frequency of 100 Hz and pulse duration of 200 \u03bcs; <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content> intensity was adjusted until the patient reported strong paresthesia. The visual numeric pain rating scale was used to assess pain intensity after each puncture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The active <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content> group reported lower pain intensity compared to the placebo <jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content> (<jats:italic>P<\/jats:italic> &lt; .0001) and control (<jats:italic>P<\/jats:italic> &lt; .0001) groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transcutaneous electric nerve stimulation (<jats:styled-content style=\"fixed-case\">TENS<\/jats:styled-content>) was effective in reducing pain intensity during carboxytherapy in patients with cellulite in the gluteal region.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.12489","type":"journal-article","created":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T12:50:59Z","timestamp":1516107059000},"page":"1175-1181","source":"Crossref","is-referenced-by-count":15,"title":["Effects of transcutaneous electrical nerve stimulation on pain intensity during application of carboxytherapy in patients with cellulite: A randomized placebo\u2010controlled trial"],"prefix":"10.1111","volume":"17","author":[{"given":"Adria Y.","family":"Sadala","sequence":"first","affiliation":[{"name":"Master's and Doctoral Programs in Physical Therapy Universidade Cidade de S\u00e3o Paulo (UNICID) S\u00e3o Paulo SP Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline F. 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